Primary Care Provider Clinics and Pharmacies

ACE primary care provider (PCP) clinics

ACE participants are either assigned to or able to choose a PCP clinic. Your assigned clinic is where you go for care. This includes care from your PCP, who leads your care team. If you ever need to see a specialist, your PCP will give you a referral.

The ACE network has seven PCP clinics. Some are part of the San Mateo Medical Center (SMMC) clinic network and others are community-based clinics in San Mateo County.

Your PCP clinic will assign you to a specific PCP at the clinic. They may be a general practitioner, a family practitioner, an internist or an OB/GYN doctor. You can choose a specific nurse practitioner or physician assistant as your PCP by selecting the clinic where they work. See tips on how to choose a PCP. You can change your PCP clinic or your PCP anytime by calling Member Services.

If you need care from a provider outside of the ACE PCP clinic network, you need to get a referral from your ACE PCP. Then the referral has to be pre-approved by HSPM.

ACE pharmacies

Prescriptions are covered only if they are filled at a network pharmacy linked to your PCP clinic. Your prescription will not be approved at a pharmacy that is not on your clinic’s list.

If your prescription is denied at the pharmacy, call your doctor. Your doctor needs to request prior authorization from HPSM to get coverage for that medicine. They can do that by filling out the Pharmacy Prior Authorization Request Form and faxing it to 650-829-2045. Your physician’s approval is required.

SMMC PCP clinics

If you are assigned to Daly City Clinic, 39th Avenue Clinic, Fair Oaks Health Center or South San Francisco Clinic, you can fill your prescriptions at any of SMMC’s five pharmacy locations. (If you are assigned to SMMC Coastside, you can only go to its linked pharmacies.)

PCP clinics linked to pharmacies